Intensive Glycemic Control in Cardiac Surgery.
Curr Diab Rep
; 16(4): 25, 2016 Apr.
Article
em En
| MEDLINE
| ID: mdl-26879308
ABSTRACT
Hyperglycemia has been found to be associated with increased morbidity and mortality in surgical patients, yet, the optimal glucose management strategy during the perioperative setting remains undetermined. While much has been published about hyperglycemia and cardiac surgery, most studies have used widely varying definitions of hyperglycemia, methods of insulin administration, and the timing of therapy. This has only allowed investigators to make general conclusions in this challenging clinical scenario. This review will introduce the basic pathophysiology of hyperglycemia in the cardiac surgery setting, describe the main clinical consequences of operative hyperglycemia, and take the reader through the published material of intensive and conservative glucose management. Overall, it seems that intensive control has modest benefits with adverse effects often outweighing these advantages. However, some studies have indicated differing results for certain patient subgroups, such as non-diabetics with acute operative hyperglycemia. Future studies should focus on distinguishing which patient populations, if any, would optimally benefit from intensive insulin therapy.
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Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Cardiopatias
/
Hiperglicemia
Limite:
Humans
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article